Abstract
Purpose
To report the characteristics and the visual and anatomical outcomes of secondary macular holes (SMHs) diagnosed after rhegmatogenous retinal detachment (RRD) repair and their associated factors.
Methods
Retrospective, interventional case series. All consecutive patients who were diagnosed with SMH after RRD repair at Beijing Tongren eye center from January 2016 to April 2021 were included. Patients who had their primary RRD repair in other hospitals and were referred to our center after diagnosis of SMH were also included. The minimum follow-up time after RRD repair was 6 months.
Results
37 SMHs were diagnosed within a series of 5696 RRDs. Including 24 eyes referred from other hospitals after the diagnosis of SMH, 61 eyes were included. The type of primary RRD repair surgery included 22/61 (36%) eyes with scleral buckling procedure (SBP) and 39/61 (64%) eyes with pars plana vitrectomy (PPV). 21/61 (34%) eyes had recurrent RD. The median time to SMH diagnosis was 150 days (range, 7 ~ 4380 days). Macular hole (MH) closure was achieved in 77% eyes. Visual acuity (VA) improvement of at least 2 lines of Snellen’s visual acuity was observed in 51% eyes. Final MH closure status was associated with preoperative MH diameter (for every 50 μm increment) (P = 0.046, OR = 0.875, 95%CI: 0.767 ~ 0.998). VA improvement was associated with final MH closure status (P = 0.009, OR = 8.742, 95%CI: 1.711 ~ 44.672). Final VA (logMAR) was associated with recurrent RD (P < 0.001, B = 0.663, 95%CI: 0.390 ~ 0.935), preoperative MH diameter (P = 0.001, B = 0.038, 95%CI: 0.017 ~ 0.058), VA at the time of SMH diagnosis (P < 0.001, B = 0.783, 95%CI: 0.557 ~ 1.009) and final MH closure status (P = 0.024, B = -0.345, 95%CI: -0.644 ~ -0.046). For patients without recurrent RD, VA improvement and final VA was associated with final MH closure status (P = 0.016 and P < 0.001, respectively), while for patients with recurrent RD, VA improvement or final VA did not associate with final MH closure status (P > 0.05).
Conclusion
For SMH diagnosed after RRD repair, final MH closure status was associated with preoperative MH diameter. Recurrent RD, larger preoperative MH diameter, worse VA at the time of SMH diagnosis and failed MH closure are predictive factors for worse final VA. Visual outcome is associated with final MH closure status in patients without recurrent RD, but not as so in patients with recurrent RD.
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Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Moshfeghi AA, Salam GA, Deramo VA, Shakin EP, Ferrone PJ, Shakin JL et al (2003) Management of macular holes that develop after retinal detachment repair. Am J Ophthalmol 136(5):895–899. https://doi.org/10.1016/s0002-9394(03)00572-5
Garcia-Arumi J, Boixadera A, Martinez-Castillo V, Zapata MA, Fonollosa A, Corcostegui B (2011) Macular holes after rhegmatogenous retinal detachment repair: surgical management and functional outcome. Retina 31(9):1777–1782. https://doi.org/10.1097/IAE.0b013e31820a69c3
Fabian ID, Moisseiev E, Moisseiev J, Moroz I, Barak A, Alhalel A (2012) Macular hole after vitrectomy for primary rhegmatogenous retinal detachment. Retina 32(3):511–519. https://doi.org/10.1097/IAE.0b013e31821f5d81
Schlenker MB, Lam WC, Devenyi RG, Kertes PJ (2012) Understanding macular holes that develop after repair of retinal detachment. Can J Ophthalmol 47(5):435–441. https://doi.org/10.1016/j.jcjo.2012.05.001
Ersoz MG, Hocaoglu M, Sayman MI, Arf S, Karacorlu M (2021) Characteristics and management of macular hole developing after rhegmatogenous retinal detachment repair. Jpn J Ophthalmol 65(4):497–505. https://doi.org/10.1007/s10384-021-00833-9
Starr MR, Lee C, Arias D, Mahmoudzadeh R, Salabati M, Kuriyan AE et al (2021) Full-thickness macular holes after surgical repair of primary rhegmatogenous retinal detachments: incidence, clinical characteristics, and outcomes. Graefes Arch Clin Exp Ophthalmol 259(11):3305–3310. https://doi.org/10.1007/s00417-021-05282-1
Khurana RN, Wykoff CC, Bansal AS, Akiyama K, Palmer JD, Chen E et al (2017) The association of epiretinal membrane with macular hole formation after rhegmatogenous retinal detachment repair. Retina 37(6):1073–1078. https://doi.org/10.1097/IAE.0000000000001307
Medina CA, Ortiz AG, Relhan N, Smiddy WE, Townsend JH, Flynn HJ (2017) Macular hole after pars plana vitrectomy for rhegmatogenous retinal detachment. Retina 37(6):1065–1072. https://doi.org/10.1097/IAE.0000000000001351
Uemura A, Arimura N, Yamakiri K, Fujiwara K, Furue E, Sakamoto T (2021) Macular holes following vitrectomy for rhegmatogenous retinal detachment: epiretinal proliferation and spontaneous closure of macular holes. Graefes Arch Clin Exp Ophthalmol. https://doi.org/10.1007/s00417-021-05183-3
Evans JR, Schwartz SD, Mchugh JD, Thamby-Rajah Y, Hodgson SA, Wormald RP et al (1998) Systemic risk factors for idiopathic macular holes: a case-control study. Eye (Lond) 12(Pt 2):256–259. https://doi.org/10.1038/eye.1998.60
Flaxel CJ, Adelman RA, Bailey ST, Fawzi A, Lim JI, Vemulakonda GA et al (2020) Idiopathic macular hole preferred practice pattern®. Ophthalmology 127(2):P184–P222. https://doi.org/10.1016/j.ophtha.2019.09.026
Wakely L, Rahman R, Stephenson J (2012) A comparison of several methods of macular hole measurement using optical coherence tomography, and their value in predicting anatomical and visual outcomes. Br J Ophthalmol 96(7):1003–1007. https://doi.org/10.1136/bjophthalmol-2011-301287
Kusuhara S, Negi A (2014) Predicting visual outcome following surgery for idiopathic macular holes. Ophthalmologica 231(3):125–132. https://doi.org/10.1159/000355492
Johnson RN, Gass JD (1988) Idiopathic macular holes. Observations, stages of formation, and implications for surgical intervention. Ophthalmology 95(7):917–924. https://doi.org/10.1016/s0161-6420(88)33075-7
Gass JD (1988) Idiopathic senile macular hole. Its early stages and pathogenesis. Arch Ophthalmol 106(5):629–639. https://doi.org/10.1001/archopht.1988.01060130683026
Gass JD (1995) Reappraisal of biomicroscopic classification of stages of development of a macular hole. Am J Ophthalmol 119(6):752–759. https://doi.org/10.1016/s0002-9394(14)72781-3
Gaudric A, Haouchine B, Massin P, Paques M, Blain P, Erginay A (1999) Macular hole formation: new data provided by optical coherence tomography. Arch Ophthalmol 117(6):744–751. https://doi.org/10.1001/archopht.117.6.744
Sonoda KH, Sakamoto T, Enaida H, Miyazaki M, Noda Y, Nakamura T et al (2004) Residual vitreous cortex after surgical posterior vitreous separation visualized by intravitreous triamcinolone acetonide. Ophthalmology 111(2):226–230. https://doi.org/10.1016/j.ophtha.2003.05.034
Chen TY, Yang CM, Liu KR (2006) Intravitreal triamcinolone staining observation of residual undetached cortical vitreous after posterior vitreous detachment. Eye (Lond) 20(4):423–427. https://doi.org/10.1038/sj.eye.6701892
Ishibashi T, Iwama Y, Nakashima H, Ikeda T, Emi K (2020) Foveal crack sign: An OCT sign preceding macular hole after vitrectomy for rhegmatogenous retinal detachment. Am J Ophthalmol 218:192–198. https://doi.org/10.1016/j.ajo.2020.05.030
Leaver PK (1995) Proliferative vitreoretinopathy. Br J Ophthalmol 79(10):871–872. https://doi.org/10.1136/bjo.79.10.871
Idrees S, Sridhar J, Kuriyan AE (2019) Proliferative vitreoretinopathy: A review. Int Ophthalmol Clin 59(1):221–240. https://doi.org/10.1097/IIO.0000000000000258
Martins MI, Bansal A, Lee WW, Oquendo PL, Hamli H, Muni RH (2023) Bacillary layer detachment and associated abnormalities in rhegmatogenous retinal detachment. Retina 43(4):670–678. https://doi.org/10.1097/IAE.0000000000003696
Funding
The study was funded by the Priming Scientific Research Foundation for the Junior Researcher in Beijing Tongren Hospital, Capital Medical University (No. 2018-YJJ-ZZL-020).
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This study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee, Beijing Tongren Hospital, Capital Medical University, approval number: TRECKY2021-151.
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Cui, Y., She, H., Liu, W. et al. Characteristics and surgery outcomes of macular hole diagnosed after rhegmatogenous retinal detachment repair. Graefes Arch Clin Exp Ophthalmol 262, 769–776 (2024). https://doi.org/10.1007/s00417-023-06259-y
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DOI: https://doi.org/10.1007/s00417-023-06259-y